Do You Know Snapping Hip Syndrome?

17 October 2019

Snapping hip syndrome can also be called Coxa Saltans. This is a very common condition especially in females, but it can happen in both genders and any age. Dancers are especially vulnerable to snapping hip syndrome. Young athletes are also susceptible to this because tightness in the muscle structures of the hip are common during growth spurts. Snapping hip syndrome is characterized as a snapping or clicking noise in or around the hip when moving. The snapping may occur when walking, standing up from a sitting position, or when swinging your leg. Snapping hip syndrome can have different causes and can be classified as either external, internal, or intra-articular. Most of the time, snapping hip syndrome is self-limiting and is an annoyance, but it can certainly cause pain and weakness which can affect one’s activities of daily living.

External snapping hip syndrome, the most common form, occurs when the iliotibial band, or also called the IT band, snaps over the great trochanter of the femur. Many times with this type of snapping hip people will have the complaint that they feel as though their hip is going to dislocate. External snapping hip syndrome comes on gradually, and not usually associated with any injury. With external snapping hip syndrome, one has a higher chance of developing bursitis in their hip which can be very painful.

Internal snapping hip syndrome is when iliopsoas tendon snaps over the bony prominence of the pelvis. Internally snapping hip syndrome comes on gradually, and is not usually associated with any injury. The symptoms of internal snapping hip syndrome include a painful sensation coming from the anterior aspect of the groin as the leg is moved from flexion into extension or externally rotated. This normally does not cause any further problems, but is more of an annoyance.

Intraarticular snapping hip syndrome is usually due a tear in the cartilage and/or if there is a loose body or foreign object within the hip and it may actually ultimately lead to the hip to “lock up”.  With intraarticular snapping hip syndrome there is a sudden onset of snapping or clicking which is the result of an injury or traumatic event to the hip.

Many times snapping hip syndrome does not cause any symptoms and usually do not require any interventions. Interventions become necessary when it is persistent and causes pain and/or activity limitations. The first and most preferred treatment approach is conservative measures. Conservative measures include: rest (avoiding activities which provoke pain/discomfort), ice, anti-inflammatory medications (which include ibuprofen and Aleve), and physical therapy. It is always important to discuss with your doctor first before taking any anti-inflammatories to ensure this is safe for you. By following a regimented physical therapy program, it is possible to regain normal function of the hip without snapping over a period of 6 to 12 months. Even after regaining normal function of the hip, it is important to continue on a consistent routine of stretching. Physical therapy exercises that can be done at home include:

- Iliotibial band stretch:

  • Stand next to a wall for support
  • Cross the leg that is close to the wall behind your other leg
  • Lean your hip towards the wall until you feel a stretch at the outside of your hip. Hold this position for 30 seconds
  • Repeat on the opposite side
  • Perform 2 to 3 sets of 4 repetitions on each side

- Piriformis stretch

  • Lie on your back with bent knees and feet flat on the floor
  • Cross the foot of the affected hip over the opposite knee and clasp your hands behind your thigh
  • Pull your thigh toward you until you feel the stretch in your hip and buttocks. Hold the stretch for 30 seconds
  • Repeat on the opposite side
  • Perform 2 to 3 sets of repetitions on each side

- Hip flexor stretch

  • Kneel on your affected leg, and bend your good leg out in front of you, with that foot flat on the ground. If you feel discomfort on the knee you are kneeling on, you can place a towel underneath that knee
  • Keeping your back straight, slowly push your hips forward until you feel as stretch in the upper thigh of your back leg and hip. Hold this position for 30 seconds
  • Repeat on the opposite side
  • Perform 2 to 3 sets of repetitions on each side

- Hamstring stretch

  • Lie flat on your back with your legs straight. You may feel discomfort in your back, if you do then place a small towel or roll under your lower back
  • Holding the back of your affected leg to provide support, lift that leg straight up and toward your body until you feel a stretch at the back of your thigh. Hold for 30 seconds
  • Repeat on the opposite side
  • Performed 2 to 3 sets of repetitions on each side

If conservative measures do not provide relief and pain/discomfort continue to the point that it is affecting activities of daily living, then at that point would surgery be considered. Surgery is always the last option to explore. Though, many of times painful snapping is successful with conservative treatment. The goal with surgery would be to relax the tendon, and correct any associated or contributing pathologies that cause the snapping, which would ultimately eliminate the snapping.